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BY CHITRA DEVI
CLINICAL PRESENTATION
HISTORY COLLECTION
PRESENTING CHIEF COMPLAINTS:
Informant says:• Muttering to self• Irritable • Laughing to self• Not sleeping well
Patient says:• Unable to sleep,
because while sleeping he is hearing a sound.
SCHIZOPHRENIA
INTRODUCTION: The word ‘schizophrenia’ was coined in
1908 by the swiss psychiatrist eugen bleuler. It is derived from the greek word
skhizo(split)and phren(mind).DEFINITION: “It is a psychotic condition characterized by
a disturbance in thinking,emotions,volitions and faculties in the presence of clear consciousness,which usually lead to social withdrawal”
ETIOLOGY:
CAUSES
Biological theories
Biochemical theories
Excess of dopamine
Abnormalities in neuro
transmittersNeurostructural theories
Genetic theories
Psychodynamic
theories Regressed id behaviour
Over protective and
domineering parents
Dysfunctional family
Vulnarability stress model
Stressful life event
•TYPES OF SCHIZOPHRENIA:
PARANOID
UNDIFFERENTIATED
HEBEPHRENIC
CATATONIC
RESIDUAL
SIMPLE
TYPES OF SCHIZOPHRENIA
PARANOID SCHIZOPHRENIA
DELUSION OF PERSECUTION
DELUSION OF JEALOUSY
DELUSION OF GRANDIOSITY
AUDITORY HALLUSINATION
DISTURBANCE OF MOTOR BEHAVIOUR
HEBEPHRENIC SCHIZOPHRENIA
THOUGT DISTURBANCE
INCOHERENCE
SEVERE LOOSENING OF ASSIOCIATION
EXTREME SOCIAL IMPAIRMENT
SENCELESS GIGGLING
CATATONIC SCHIZOPHRENIA
INCREASE IN SPEECH PRODUCTION
LOOSENING OF ASSOCIATION
MUTISM , ECHOLALIA
RIGIDITY , ECHOPRAXIA
NEGATIVISM , WAXYFLEXIBILITY
POSTURING
• INCREASE IN PSYCHOMOTOR ACTIVITY
• AMBITENDENCY
• STUPOR
RESIDUAL SCHIZOPHRENIA
Emotional blunting
Eccentric behaviour
Illogical thinking
Social withdrawal
Loosening of association
PAST EXPERIENCE
Prenatal exposure to viral infection
GENETIC INFLUENCE
Family history of schizophrenia Possible birth defect
PRECIPITATING EVENT
Stressful to threaten Already weak ego
Defence mechanism used are DENIAL, INDICATION,RELIGIOUSITY, RECURRECTION
SECONDARY
Unable to use coping mechanism Weak ego strength
COGNITIVE APPRAISAL(PRIMARY)
Perceived threat to self concept
EXISTING CONDITION
Abnormal brain structure , Epilepsy,
Hallucination , delusion, social isolation, violence, autism , apathy, bizzare , behaviour &inappropriate
affect
Initial psychotic episode, exacerbation of schizophrenic symptoms
QUALITY OF RESPONSE
AdaptiveMaladaptive
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